At the French Nutrition Days 2025 in Lyon, France, Sandrella Hamdan, DDS, dental surgeon from the Department of Pediatric Dentistry, Faculty of Dental Surgery, Paris Cité University in Paris, France, outlined pediatric eating disorders and their oral health consequences, emphasizing the need for early prevention and multidisciplinary management.

“When children experience eating difficulties, they tend to turn to sugary foods,” she said.

Early Caries

In children, the pleasure of eating develops through repeated exposure to stimuli, as Hamdan noted. “At first, a child may have an opinion. Then, because they are offered food several times, they may change their minds.” However, “if we have negative experiences early on, we have difficulty having positive experiences later. This is common in premature babies.”

According to the literature, children aged 2-5 years can chew and swallow in a manner similar to adults. “However, infantile swallowing patterns often persist.” When feeding difficulties occur, children tend to prefer sweet foods.

“The recommendations often support milk feeding for an extended period because children readily accept it. However, the concern is that ongoing bottle use can lead to oral complications, including dysmorphoses, such as incorrect tongue positioning and the development of an open bite,” she said.

A diet high in sugar and ultraprocessed foods is associated with a risk for early childhood caries.

“A more acidic oral pH reduces saliva’s ability to protect the teeth. Some children develop cavities that affect all teeth as early as 2 years of age. Those with high sugar intake and frequent small meals are at a higher risk, as this pattern limits the time saliva needs to act protectively,” she said. “When combined with refusal to brush teeth, the situation can quickly become critical,” Hamdan said.

Dental arch deformities should be corrected as early as possible for both functional and aesthetic reasons.

Permanent Damage

Treating cavities in primary teeth is essential because they can lead to infection. Chewing efficiency declines when dental decay involves all the teeth. In primary teeth, cavities can extend deep into the teeth and affect the developing permanent teeth, which may impair normal growth or lead to abnormalities in shape or color.

Enamel defects or damage can also result in permanent teeth that are less resistant or have an altered appearance. Therefore, dental arch deformities should be corrected as early as possible. “This is important for both aesthetic and functional reasons, as deformities or an open bite can interfere with proper swallowing,” she added.

“Contact between the teeth also helps protect them during impact. When this contact is disrupted, the risk for dental trauma increases, which can lead to fractures or even tooth loss,” Hamdan explained.

The growth of permanent teeth may be impaired, or teeth may develop abnormalities in shape or color.

Enamel defects can result in permanent teeth that are less resistant to decay or aesthetically compromised. Therefore, dental arch deformities should be corrected early.

“The reason is both aesthetic and functional because appropriate swallowing becomes more difficult with deformities or open bite,” she said. “In addition, contact between teeth helps protect them during trauma, so these deformities increase risk for dental injury, including fractures or tooth loss.”

Nutritional Deficits

Malnutrition and undernutrition can contribute to oral diseases, even in children. Vitamin A deficiency is associated with bone loss, oral ulcers, delayed wound healing, and increased susceptibility to infections.

Vitamin B deficiency can cause inflammation, while vitamin C deficiency presents features such as scurvy in adults. Vitamin D deficiency may lead to loss of tooth attachment and enamel damage, whereas vitamin K deficiency can result in bleeding.

“Children with feeding difficulties, problems with toothbrushing, and oral dysfunctions may also develop an early gag reflex, which further complicates care for both parents and healthcare professionals,” Hamdan said.

“Management includes improving oral hygiene and working with speech therapists and dietitians to support these children. The process is often prolonged, and symptom improvement is limited. When clinical signs of deficiency are present, supplementation may be recommended,” she concluded.

Hamdan reported having no relevant conflicts of interest.

This story was translated from Medscape’s French edition.